You may print this order form to fax or mail your order to us.

Carol Rabius, 271 North Ave PH3, New Rochelle,NY 10801

Carol at (914) 712-1481 fax (914) 235-6954 [email protected]

If you prefer to order by phone, please do so. If you do not reach us, leave your phone number and best time to call and we will return your call. Thank you.

Ship to :____________________________________________

Address____________________________________________

e-mail address:_______________________

Daytime Telephone___________________ EveningTelephone___________________

Item Name ________________ Qty__________ Cost__________

Item Name ________________ Qty__________ Cost__________ $4.00 min. Shipping

over $125. $8.00 Shipping________________________

over $150. 9.00

over $200. 12.00 Total Enclosed___________________

Method of Payment - Check /M.O/ Date_________

Signature__________________________________________